Is India Prepared To Handle A Viral Outbreak?

- Amit Bhalerao

The world is facing a new pathogen called Coronavirus originated in Wuhan, China. The virus has spread to 16 countries such as the USA, Germany, France, and Australia. As of now, 11,800 people have been diagnosed with the virus and the death toll has reached 250 people. The virus is not fatal to younger people and is only affecting older people or people who have any kind of pre-existing illness.

The Chinese Government has very effectively handled the whole situation if the data given by them is true. China has already faced a similar outbreak from another Coronavirus, SARS, which caused Severe Acute Respiratory Syndrome (SARS) in 2003. According to the WHO database, the number of infected was 5327 and the death toll was 349. The final fatality rate of the virus was 6.6% while the current fatality rate of Coronavirus is 3.3 %. If we compare these numbers to the current outbreak we can conclude that China has learned a lot about handling such outbreaks. It also has become more transparent while sharing the outbreak data to international medical and health organizations. This will be a tougher test for the Chinese Health Ministry as the virus is spreading more rapidly than the SARS but if we are talking about effectiveness in controlling a disease then the final death count will be the parameter used for judging China's response.

India is a tropical country except for its Northern part. The rise of such viral outbreaks is inevitable due to tropical regions facing most of the extremities of climate change. The question with regards to the rapid spread of the virus then is that, is India prepared if a similar outbreak occurs within the populace?

We will go through the current status of Indian health infrastructure as well as a few other factors which contribute to effective control of a virus as well as the overall health of a nation.

The Health Infrastructure of India

As per the National Health Profile 2019 released by the Central Bureau of Health Intelligence (CBHI), there are 25,778 Government hospitals in rural plus urban areas combined. The total number of beds available is 7,13,986.

As per the World Health Organization's (WHO) guidelines, the minimal ratio of doctor-patient in any country should be 1:1000 ideally. In India, this ratio is 1:10,926. There is only one allopathic Government doctor available for 10,926 Indians.

The total expenditure on the health sector is 1.28 percent of the country's GDP. This is lower than many of the poorer countries of Asia.

Compare this situation to the Chinese Health administration building a new 1000-bed hospital in Wuhan after the death count reached to 15. Can we do so if an outbreak occurs? Absolutely yes. Do you expect the Government to do so after an outbreak? Definitely not as soon as the Chinese Government did.

India limited the spread of Nipah virus case in 2018 in successfully. But the Nipah virus wasn't a new virus at the time and the good coordination between the Central and State medical officials proved to be very effective.

We can expect a similar performance from the people within the Health Infrastructure if the Government equips them with advanced testing kits, personal protective equipment, and guidelines.

Containment of Virus

The most important step in any viral outbreak is containment. If the virus is quarantined early and within a very small area the treatment and control become much easier. China has quarantined the Wuhan City. The in and out transit has been completely shut off from the past seven days. People are either given holidays for the next two weeks or told to work from home just to ensure that physical contact is as minimal as possible.

This is the hardest part of containing a virus outbreak in India. The growing population plus the congregations we see in our public transport make it impossible to believe that such viral outbreak can be easily controlled in India. Yes, it is easy to prevent transits of airlines and seaports but we cannot control the rail transit outbreak. Any Central Line train at peak hours carries around 6500 people. If anyone carrying a virus is on this train, he can easily transmit this virus to a large number of people. The Urban and semi-urban population of Mumbai is already suffering from viral fever for two weeks because of this only. As per the National Health Profile 2019 report, the total number of Railway hospitals in our country is just 122 which is housing a total of 13,355 beds.

To be prepared for such an outbreak, the Railway Ministry of India needs to modernize its preexisting medical infrastructure. Heat scanners and experienced medical staff should be available at entry points of major Railway Stations just in case of any outbreak occurs.

The late Prime Minister Indira Gandhi once said that Poverty and Pollution go hand in hand. She would agree if we add 'Disease' too in the line. The health of the workers at dumping grounds or the sewers is already neglected in our country. If a new viral outbreak occurs in their slums or ghettos, first, the disease will go unnoticed for a few days and by the time it gets the attention, it would have been spread to a large population. The Government needs to take the health and safety of these people seriously. Their lives are already on the line because of the work they do.

The population of India is the biggest challenge our country will face in such conditions and we need to take measures to create a greater health infrastructure equipped with all the necessities to contain any outbreak.

Lack of General Awareness

Most of the rural part of India is unaware of general sanitation practices. The much talked and glorified Swacch Bharat Abhiyaan (Gramin) was nothing more than a media friendly exercise. Media outlets like 'Down To Earth' have already shown the problematic parts of this whole program through their ground reports. Improper construction of toilets, failure in treating the grey water and constructing toilets without providing a source of water at the site. The list goes on.

India needs to provide these people with proper guidelines and medical care as much as possible. Teaching good sanitary practices is not much of a hassle and we have seen sanitation of many villages improved because of this. Once people become aware of new diseases they will follow the Do's and Dont's advised by the Government if a case of infection takes place in their region.

Availability of Drugs

When India faced the Nipah virus in 2018, it had to import the drugs from Australia. The time taken for this transport can be fatal and thus the Government needs to boost drug research and development in India. Such outbreaks will be becoming common in the coming years and India is to be prepared if it want equally effective treatment provided to everyone regardless of their financial status.

These are some of the factors which are important for reaching a final conclusion. If it can check all the boxes positively then yes, India is prepared for a viral outbreak, But saying that will be an overstatement. India is not there yet but we are improving slowly and there is a long way ahead. If you want to tackle any disease then you have to take epidemiological, ecological and socio-economical factors into consideration. When the policymakers start thinking and making health policies based on these three fronts then only will rural India with urban India be prepared to face a viral outbreak in the coming future.